| NPI | 1790899821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 110157) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 30969) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2016-01-08 |